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Bipolar Disord. 2009 Jun;11(4):391-400. doi: 10.1111/j.1399-5618.2009.00686.x.

Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study.

Author information

  • 1Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, ACC 812 15 Parkman Street, Boston, MA 02114, USA. rperlis@partners.org

Abstract

OBJECTIVE:

Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms.

METHODS:

We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry.

RESULTS:

Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups.

CONCLUSION:

Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.

PMID:
19500092
[PubMed - indexed for MEDLINE]
PMCID:
PMC3992980
Free PMC Article

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